Psychosocial and pharmacological treatment of patients following deliberate self-harm: the methodological issues involved in evaluating effectiveness.

Development of effective treatments for patients following deliberate self-harm (self-poisoning or self-injury) is a very important element in suicide prevention. The randomized controlled trial (RCT) is the mainstay of evaluation of treatments. In a systematic review of the literature, the effectiveness of treatments based on RCTs was examined and the quality of the RCTs was assessed. Twenty trials were identified, and where possible, these were grouped on the basis of similarities among the types of treatment. In this paper, we examine the methodological aspects of the trials and consider what may be learned that will assist in the design of future studies in this field. The methodological quality of the trials was reasonable, but most trials included too few participants to detect clinically important differences in rates of repeated self-harm. In planning future trials, the following major issues should be addressed: investigators should perform power calculations to determine the number of subjects necessary to detect clinically important effects, provide information on method of randomization and interventions, use standard measures of outcome, and focus on homogeneous subgroups of patients. Improving the methodology of future studies in this field will be essential if sound evidence is to be obtained which can inform effective service provision for deliberate self-harm patients.     

Experimental components analysis of brief theory-based HIV/AIDS risk-reduction counseling for sexually transmitted infection patients.

An experimental components analysis of brief HIV risk-reduction counseling based on the information-motivation-behavioral skills (IMB) model was conducted with 432 men and 193 women receiving sexually transmitted infection (STI) clinic services. Following baseline assessments, participants were randomly assigned to 1 of 4 90-min risk-reduction counseling sessions that deconstructed the IMB model within a full factorial design. Participants were followed for 9 months, with STI diagnoses monitored over 12 months. Men who received the full IMB session evidenced relatively greater use of risk-reduction behavioral skills and relatively lower rates of unprotected intercourse over 6-months follow-up and had fewer new STIs. For women, however, the motivational counseling demonstrated the most positive outcomes. Results suggest that brief single-exposure HIV prevention counseling can reduce HIV transmission risks.     

Books received

I argue that there are phenomenological constraints on what it is to see an object, and that these are overlooked by some theories that offer allegedly sufficient causal and counterfactual conditions on object-seeing.     

Context-sensitive elemental theory

My theories of associative learning, like those of N. J. Mackintosh and almost all learning theorists, have employed elemental representations of the stimuli involved. We must take notice when two important contributors to elemental theory, J. M. Pearce and W. K. Estes, find sufficient problems with the theory type to cause them to defect from it. I will describe some of the essential problems, concerning the substantial influence of context on learning and retrieval, characterize the different responses of Pearce and Estes, and, then, propose a variation on a recently developed elemental model that was similarly inspired. The resulting elemental theory has a close quantitative relationship to the “product-rule” of Estes and D. L. Medin, and may help us to rationalize how the same formal experimental design can sometimes produce results that favour the configural interpretation of Pearce and at other times the elemental interpretation of R. A. Rescorla and A. R. Wagner, as these have often been pitted against each other.